Ralph Carmel, one of the modern scientists who has studied B12 most thoroughly, comments in one of his studies: Most of the newly recognized deficiency is subclinical in nature, with an uncertain impact on health. The prevalence has increased with the inclusion of people with normal B12 levels, some of whom are deficient. Folic acid fortification of some products/foods has raised concerns about the potential adverse neurological consequences of folate in people with undetected B12 deficiency. NOTE: Deficiency IS NOT THE SAME AS symptoms (there may be temporary asymptomatic deficiency) and the onset of symptoms is variable and interindividual
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Further guidance on assessment and management of B12 deficiency is available via NICE Clinical Knowledge Summary (CKS): Anaemia B12 and folate deficiency
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Symptoms of vitamin B12 deficiency: extreme tiredness a lack of energy pins and needles a sore and red tongue mouth ulcers muscle weakness problems with your vision psychological problems, which can range from mild depression or anxiety to confusion and dementia problems with memory, understanding and judgement Causes of a vitamin B12 deficiency: pernicious anaemia a lack of these vitamins in your diet medicine certain medicines, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs
